Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel.A random sample of 234 female and 953 male ambulance personnel participated in a national questionnaire survey on work-related factors, and musculoskeletal and other health complaints. Physical demands was associated with activity limitation due to neck-shoulder and low-back complaints among the female personnel. Among the male personnel, physical demands was associated with low-back complaints and activity limitation due to low-back complaints. Psychological demands was significantly associated with neck-shoulder complaints, sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Worry about work conditions was associated with musculoskeletal disorders and sleeping problems, headache and stomach symptoms.A local sample of 26 ambulance personnel was followed during a 24-hour work shift and for the next two work-free days. Subjective stress- and energy levels, and cortisol levels were measured at regular intervals, and heart rate was registered continuously by electrocardiogram (ECG). Autonomic reactivity to standardized tests before (pre-work) and at the end of the work shift (post-work) was also investigated. For the whole group, baseline values of heart rate were higher pre-work than post-work, but autonomic reactivity did not differ. Increased reactivity to the mental test, modest deviation in heart rate variability (HRV) pattern during the late night hours at work and higher morning cortisol values during work than during leisure time were observed in personnel with many health complaints, but not among their co-workers without or with few complaints. Ambulance personnel with many health complaints also reported higher psychological demands and tended to be more worried about work conditions.Heart rate (HR), lactate level (LL) and perceived exertion (RPE) were investigated in 17 female and 48 male ambulance personnel during a simulated standardized work task “carry a loaded stretcher”. The ambulance personnel had to carry the loaded stretcher (920 N) up and down three flights of stairs twice. The high physiological strain (HR, LL, RPE) for the male, and near or at maximal strain for the female ambulance personnel, implied the importance to identify what kind of physical capacity is most important for ambulance personnel. Therefore, the explained variance of developed fatigue by tests of cardiorespiratory capacity, muscular strength and endurance, and coordination was investigated. The results showed that VO2max and isometric back endurance were important predictors for development of fatigue when carrying a loaded stretcher.The influence of body size on the relationships between maximal strength and functional performance was investigated in a methodological study. The results confirm that the assessment of physical performance could be confounded by the body weight. Therefore, the models for explaining development of fatigue when carrying the loaded stretcher were adjusted for height and weight. Including height in the models significantly increased the explained variance of accumulated lactate among female, but not among male personnel. Lactate levels were higher among short compared to tall female personnel. Weight had no effect on any of the models.In conclusion, the national survey showed that self-reported physical demands was a risk factor of having MSDs, and that self-reported psychological demands and worry about work were important risk factors of having MSDs and other health complaints. Stress monitoring of ambulance personnel during work and leisure time showed that physiological and subjective stress markers did not show any differences between the 24-hour ambulance work shift and leisure time afterwards. However, ambulance personnel with many health complaints had certain physiological changes during the work shift in comparison with the next two work-free days. The physiological and subjective responses during carrying a loaded stretcher, especially among the female ambulance personnel, showed that female and male ambulance personnel could be exposed to internal exposures at different levels when performing the same work task. A better understanding of the relationships between occupational demands and health-related outcomes require further studies on age- and gender matched groups in long-term perspective studies.

Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P&lt; 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P&lt; 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P&lt; 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P&lt; 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

Recent research has shown significant associations (negative and positive) between religious and spiritual factors and mental health. Much of this research, however, has been conducted in the US, where religion is an integrated part of most people’s lives. Other studies on religious and spiritually oriented coping conducted outside the US have also focused on religious people. Yet many are non-believers, and many believers do not consider themselves religious, i.e. religion is not an important part of their life. There are also societies in which the dominant culture and ways of thinking dismiss the role of religion in people’s lives. Research on religious coping rarely takes these people into consideration. Thus, the following questions arise: How are religion and spirituality involved in coping when non-believers or non-religious people face difficult events? How do culture and ways of thinking affect people’s choice of religious and spiritual coping methods? Proceeding from a cultural approach to coping and health, this book attempts to address these questions by looking at the coping strategies of Swedish cancer patients.

This paper proposes three novel models for behavioral modeling and digital pre-distortion (DPD) of nonlinear 2 x 2 multiple-input multiple-output (MIMO) transmitters in the presence of crosstalk. The proposed models are extensions of the single-input single-output generalized memory polynomial model. Three types of crosstalk effects were studied and characterized as linear, nonlinear, and nonlinear &amp; linear crosstalk. A comparative study was performed with previously published models for the linearization of crosstalk in a nonlinear 2 x 2 MIMO transmitter. The experiments indicate that, depending on the type of crosstalk, the selection of the correct model in the transmitter is necessary for behavioral modeling and sufficient DPD performance. The effects of coherent and partially noncoherent signal generation on the performance of DPD were also studied. For crosstalk levels of 30 dB, the difference in the normalized mean square error and adjacent channel power ratio was found to be 3-4 dB between coherent and partially noncoherent signal generation.

The demands for high data rates and broadband wireless access require the development of wireless systems that can support wide and multi-band signals. To deploy these signals, new radio frequency (RF) front-ends are required which impose new challenges in terms of power consumption efficiency and sources of distortion e.g., nonlinearity. These challenges are more pronounced in power amplifiers (PAs) that degrade the overall performance of the RF transmitter. Since it is difficult to optimize the linearity and efficiency characteristics of a PA simultaneously, a trade-off is needed. At high input power, a PA exhibits high efficiency at the expense of linearity. On the other hand, at low input power, a PA is linear at the expense of the efficiency. To achieve linearity and efficiency at the same time, digital pre-distortion (DPD) is often used to compensate for the PA nonlinearity at high input power. In case of multi-channel PAs, input and output signals of different channels interact with each other due to cross-talk. Therefore, these PAs exhibit different nonlinear behavior than the single-input single-output (SISO) PAs. The DPD techniques developed for SISO PAs do not result in adequate performance when used for multi-channel PAs. Hence, an accurate behavioral modeling is essential for the development of DPD for multi-channel RF PAs. In this thesis, we propose three novel behavioral models and DPD schemes for nonlinear multiple-input multiple-output (MIMO) transmitters in presence of cross-talk. A study of the source of cross-talk in MIMO transmitters have been investigated to derive simple and powerful modeling schemes. These models are extensions of a SISO generalized memory polynomial model. A comparative study with a previously published MIMO model is also presented. The effect of coherent and partially non-coherent signal generationon DPD performance is also highlighted. It is shown experimentally that with partially non-coherent signal generation, the performance of the DPD degrades compared to coherent signal generation. In context of multi-channel RF transmitters, PA behavioral models and DPD schemes suffer from a large number of model parameters with the increase in nonlinear order and memory depth. This growth leads to high complexity model identification and implementation. We have designed a DPD scheme for MIMO PAs using a sparse estimation technique for reducing model complexity. This technique also increases the numerical stability when linear least square estimation model identification is used. A method to characterize the memory effects in a nonlinear concurrent dual-band PAs is also presented. Compared to the SISO PAs, concurrent dual-band PAs are not only affected by intermodulation distortions but also by cross-modulation distortions. The characterization of memory effects inconcurrent dual-band transmitter is performed by injecting a two-tone test signal in each input channel of the transmitter. Asymmetric energy surfaces are introduced for the intermodulation and cross-modulation products, which can be used to identify the power and frequency regions where the memory effects are dominant.

The indirect learning architecture (ILA) is the mostused methodology for the identification of Digital Pre-distorter(DPD) functions for nonlinear systems, particularly for highpower amplifiers. The ILA principle works in black box modelingrelying on the inversion of input and output signals of thenonlinear system, such that the inverse is estimated. This paperpresents the impact of disturbances, such as noise in the DPDidentification. Experiments were performed with a state-of-artDoherty power amplifier intended for base station operationin current telecommunication wireless networks. As expected,a degradation in the performance of the DPD (measured innormalized mean square error (NMSE)) is found in our experiments.However, adjacent channel power ratio (ACPR) canbe a misleading figure of merit showing improvement in theperformance for wrongly estimated DPD functions.